Q: What is HGE?
Hemorrhagic Gastroenteritis (or HGE) is a serious and potentially fatal disease of the intestinal tract. The cause is unknown, and this condition occurs most commonly in smaller breed dogs, although it can arise in any breed. The onset of bloody diarrhea is quick and dehydration occurs rapidly. Vomiting also commonly occurs. If not treated promptly, the dog may go into shock.
No specific tests are available to diagnose HGE, however, a packed cell volume (PCV) being elevated along with clinical signs and physical exam lead to a diagnosis. A normal PCV for a healthy dog would be 37-55%, meaning 37-55% of the blood volume should be red blood cells (the rest being fluid and white blood cells). When a patient becomes very dehydrated, there is less fluid in the blood stream, and the result is a rising percentage of red blood cells. A dog with HGE will have a PCV greater than 60%. Measurement of total protein is often done with a PCV.
Dogs with HGE will have a lower than normal total protein.
During an episode of hemorrhagic gastroenteritis, the intestinal lining and intestinal blood vessels become permeable to fluid. Fluid and associated proteins leak out of the blood vessels and into the intestine. The blood cells are too large and stay behind. It is in this way that fluid is lost into the intestine, causing diarrhea and dehydration. The PCV rises and the total protein decreases.
Treatment involves hospitalization and appropriate intravenous fluid therapy. Symptoms such as vomiting and nausea can be controlled with medications by injection since the patient should not receive anything by mouth for at least one day. A bland diet can be added slowly while continuing fluid support. Aggressive fluid therapy will decrease the PCV into a normal range and prevent the patient from going into shock. Often antibiotics are indicated as well. It is usual for the patient to be hospitalized for several days receiving IV fluid support.
It is not contagious or genetic, and we still need further research into the cause as it remains unknown. Sometimes, stress or hyperactivity precedes the onset of disease.
Q: What is IBD?Inflammatory Bowel Disease (IBD) is a complex set of diseases all grouped together as IBD. There are different types of inflammatory bowel disease and the only way to definitively diagnose it is via intestinal biopsy and histopathology. Therefore, IBD is a disease that can be difficult to diagnose since many other causes of diarrhea present similarly to IBD. Inflammatory bowel diseases are the most common cause of long-term vomiting and diarrhea in dogs and cats. The cause of IBD is not completely understood. The gastrointestinal tract becomes invaded by inflammatory cells, including lymphocytes, plasma cells, eosinophils, macrophages, and/or neutrophils. These infiltrates cause damage to the mucosal lining of the intestines, causing diarrhea and/or vomiting. It is believed that with IBD, the immune system reacts abnormally to normal bacteria in the intestines.
Diagnosis is based on clinical signs (chronic diarrhea, vomiting, and weight loss) in addition to the exclusion of other diseases causing similar symptoms. Other diseases include metabolic disease, infectious disease, obstructive disorders and neoplasia. To confirm the diagnosis of IBD, biopsies must show histological evidence of cellular infiltrates and changes to the intestinal architecture.
Dietary treatment is of utmost importance. Up to 60% of dogs and cats with IBD will benefit from a special diet prescribed by your veterinarian. Sometimes antimicrobial therapy is necessary as well as a novel diet. Immunosuppressive drugs such as prednisone or cyclosporine are reserved for cases that fail to respond to nutritional and antimicrobial therapy.
There is no cure for inflammatory bowel disease. It is a disease that is controlled and relapses are possible. Dietary compliance is important.
Dr. Dye practices at Clevengers Corner Veterinary Care and can be reached at 540-428-1000 or through ClevengersCorner.com.